STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, ~ Vv. . CASE NO. 2002-15808 JELENA KAMEKA, M.W., a/k/a JENNA KAMEKA, RESPONDENT. ADMINISTRATIVE COMPLAINT Petitioner, Department of Health, by and through undersigned ; counsel, files this Administrative Complaint before the Department of Health against Respondent, Jelena Kameka, M.W., and in support thereof alleges: 1. Petitioner is the state department charged with regulating the practice of midwifery pursuant to section 20.43, Florida Statutes (2002), and chapters 456 and 467, Florida Statutes (2002). | | 2. At all times material to this Complaint, Respondent was a licensed midwife within the State of Florida, having been issued license number MW 81. K:VignncioEX\Ac‘s\Kanaka 2002-15808 ACdoc pOd Be*OL 9008 é6 unr Fe:oT 900¢ Ze Unt A A 3. Respondent's address of record is 4811 129th Ave. North, Royal Paim Beach, Florida 33411. 4. | Patient JMF was primipara (with first child). 5. In or about January 2002, patient JMF contacted Respondent to arrange for Respondent to provide midwifery services to patient JMF. ) 6. Onor about January 18, 2002, Respondent began providing midwifery services to patient JMF, including, but not limited to, monitoring the status of JMF’s pregnancy, patient JMF, and patient IMF's fetus. 7. Onor about April 29, 2002, at about 3:00 a.m., patient IMF's water broke at her residence. 8. At about 7:00 a.m., about four (4) hours after patient IMF's water broke, patient JMF contacted Respondent and informed Respondent that her water broke at about 3:00 am, earlier that morning. 9. Upon being informed that patient JMF’s water broke, Respondent failed to immediately assume and/or immediately arranged for the care of patient IMF. 10. Respondent first assumed the care of patient JMF when Respondent arrived at patient JMF’s residence at about 4:00 p.m., which was about thirteen (13) hours after patient JMF's water broke. | 2. Ke Vignsdo acs ameka 2002425008 ACCC s0‘d BerOk g00@ ¢e une Se:0T 900¢ Zé Unt A A 11. From the time Respondent was first informed at 7:00 a.m. of patient JMF’s water breaking, to the time Respondent assumed the care of patient IMF at 4:00 p.m., approximately nine (9) hours had elapsed. 42. During this nine (9) hour period, Respondent was unable to monitor the status and/or condition of patient IMF's labor, patient IMF, and/or patient JMF’s fetus, and Respondent was unable to determine whether patient JMF and/or patient IMF's fetus were experiencing complications and/or distress. 13, When Respondent arrived at patient JMF’s residence about nine (9) hours after being informed that patient JMF’s water broke, patient JMF - was still not exhibiting regular contractions and had not progressed | normally; approximately thirteen (13) hours had elapsed since patient IMF's water broke. 14. A mother's failure to have regular contractions within twelve (12) hours after her water breaks greatly increases the risk and chances of infection for both mother and baby. _ | , | 15. By 9:00 p.m., Respondent had not administered antibiotics to patient JMF; approximately eighteen (18) hours had elapsed since patient JMF’s water broke. eNignacioBX\ACs\Rarnek 2002-15808 AC.doe 40 °d BerOk 9008 ¢@ une S2:0T 900¢ 2@ Unc an o~ 16. A mother’s failure to receive antibiotics intravenously eighteen (18) hours after her water breaking greatly increases the risk and chance for infection for the mother and fetus. 17. At about 11:00 p.m. that evening, Respondent requested the assistance of Bella Lauren, a licensed midwife in the State of Florida with license number MW 121, and Lauren arrived at patient JMF's residence approximately twenty (20) hours after patient JMF’s water broke. 18. The next morning, on or about April 30, 2002, at about 2:00 a.m., Respondent instructed patient JMF to begin pushing; approximately twenty-three (23) hours had elapsed since patient JMF’s water broke. 19, After about one hour of pushing at the instruction of Respondent and Lauren, patient JMF still failed to progress normally. 20. That afternoon, at about 12:30 p.m., Respondent allowed Lauren to administer Pitocin with a hypodermic needle to patient JMF in an attempt to induce labor; about twenty-nine and a half hours (29 ¥2) hours had elapsed since patient JMF’s water broke. , 21. _ Pitocin, also known as oxytocin, is the synthetic form of the “hormone oxytocin, and Pitocin causes contractions and induces and/or stimulates labor. Se: VignicloEX\AC's\Rameks 2002-45808 AC.doe é0‘d pero 9008 ge unr Se:0T 900¢ Zé Unt a ~ 22. Based-on'the standards of the practice of midwifery and pursuant to Rule 64B24-7.011(3)(a), Florida Administrative Code (2001), a midwife shall only administer Pitocin postpartum (after childbirth) and through an intravenous drip. 23. Using a hypodermic needle to administer Pitocin intrapartum (during labor) greatly increases the risk and danger to the mother and baby, including, but not limited to, a stroke, an abrupted placenta, a blown uterus, or a continuous contraction that could suffocate the baby, and should not be administered by a midwife intrapartum without consulting a physician. | | 24. Upon being administered Pitocin, patient JMF immediately began to experience adverse reactions to the Pitocin, including, but not limited to, extreme pain, convulsions, and spasms. 25. After the administration of Pitocin, patient JMF’s labor still failed to progress normally and patient JMF failed to exhibit regular contractions. 26. ‘That evening, at about 6:00 p.m., Respondent called | Wellington Regional Medical Center (Wellington), a hospital in West Palm Beach, Florida, in order to arrange the transfer of patient JMF’s care to a we SG gredinEX\Ars\Kamake 2002/25308 ACCOC 80 ‘d pero 9008 ge unr Se:0T 900¢ Zé Unt ty . oN nn) physician at the hospital; approximately thirty-nine (39) hours had elapsed . since patient JMF’s water broke. | 27, When Respondent contacted Wellington, Respondent falsely reported that patient JMF’s water broke at 5:00 a.m., April 30, 2002. 28. At about 7:00 p.m., the care of patient JMF was finally transferred to Wellington and patient JMF was admitted into the emergency room; approximately forty (40) hours had elapsed since patient IMF's water broke. 29. From the time Respondent was informed that patient JMF’s water broke on or about April 29, 2002, at about 7:00 a.m., to when Respondent finally transferred patient JMF’s care to Wellington on orabout - April 30, 2002, at about 7:00 p.m., Respondent never consulted, referred, or transferred patient JMF’s care to a physician with hospital obstetrical privileges despite patient JMF’s failure to progress in dilation and descent after twenty-four (24) hours of patient JMF's water breaking. 30. Respondent accompanied patient JMF when patient IMF was admitted into Wellington. K:\ignacibEx\Wacs\Kamekn 2002-15608 AcJdoc 60 "d perok 9008 ¢@ une 92:07 900¢ Zé Unt 31. When the attending physician asked patient JMF and Respondent who was the midwife that had been caring for patient IMF, Respondent stated “Jenna Kameka.” 32, Respondent, however, misled the attending physician by failing to clarify and/or further indicate to the attending physician that she was the midwife “Jenna Kameka” that had been caring for patient JMF. | 33. Based on the standards of the practice of midwifery, during a transfer of a patient's care to a physician, a midwife shall provide adequate patient records pertaining to the status/and or condition of the labor, the ‘mother, and the fetus. ° 34 When Respondent transferred patient JMF's care to the attending physician at Wellington, Respondent failed to provide adequate patient records pertaining to the status and/or condition of patient JMF’s labor, patient JMF, and patient IMF's fetus. COUNT ONE 35. Petitioner realleges and incorporates paragraphs one (1) through thirty-four (34) as if fully set forth herein. 36. Section 467.203(1)(j), Florida Statutes (June 2001), sets forth grounds for disciplinary action by the Council of Licensed Midwifery and - ; 7 kevignacioexacn\kamed 2002-15808 AC.doc Ol ‘d perok 9008 ¢@ une 92:0T 900¢ 42 Unc ' rn ~ provides that violating any provision of chapters 467 or 456, Florida Statutes (2001), 0 disciplinary action. r any rules pursuant thereto, constitutes grounds for that as part of a midwife’s responsibility during intrapartum: 1. Upon initial assessment, the midwife shall: (a) Determine the onset of labor; (b) Review patient's prenatal records; (c) Assess condition of mother and fetus; (d) Access delivery environment; [and] (e) Perform sterile vaginal examinations to initially assess cervical dilation and effacement, presentation, position and station of the fetus, and the status of membranes. Throughout active labor, the midwife shall: .. . (c) Monitor, assess and record the status of labor and the maternal and fetal condition: (d) Measure blood pressure every hour until cervix is dilate to 8 cm., then every half hour after rupture of mernbranes; (e) Take the patient's pulse every two (2) hours while membranes are intact and temperature is normal, then every hour after rupture of membranes; (f) Take temperature every four (4) hours, or more frequently if maternal conditions warrants, and every hour if elevated to 100- degrees F or above: (g) Estimate fluid intake and urinary output at feast every two (2) hours; and (h) Assess for hydration and edema. . . . S2\IgnacioEXWAC's\Rameka 7002-15808 ACdoc Lk “d 9e7Ol 9008 é6 unr 92:07 900¢ Zé Unt 37. - Rule 64B24-7.008, Florida Administrative Code (2001), states rn . o—~ 38. Respondent violated Rule 64B24-7.008, Florida Administrative Code (2001), by not performing the duties under this Rule until nine (9) hours after being informed of JMF’s water breaking. . 39. Based on the foregoing, Respondent is subject to discipline pursuant to section 467.203(1)(), Florida Statutes (June 2001), by violating Rule 64B24-7.008, Florida Administrative Code (2001). COUNT TWO 40, Petitioner realleges and incorporates paragraphs one (1) through thirty-four (34) as if fully set forth herein. 41, Section 456.072(1)(a), Florida Statutes (2001), sets forth grounds for disciplinary action by the Council of Licensed Midwifery and provides that making misleading, deceptive, or fraudulent representations in or related to the practice of the licensee's profession constitutes grounds for disciplinary action. 42. Respondent made a misleading representation to Wellington by . falsely reporting that patient JMF’s water broke on or about April 30, 2002, at about 5:00 a.m. 43. Respondent made a misleading representation to patient JMF’s attending physician at Wellington by failing to clarify and/or further Indicate 9 SVlgnackoXVACeixe meta 2002-15308 AC dor él‘d GerOk 9008 ¢e une 92:07 900¢ Zé Unt - ~ to the attending physician that she was the midwife “Jenna Kameka” that had been caring for patient IMF. . 44, . Based on the foregoing, Respondent violated section 456.072(1)(a), Florida Statutes (2001), by making misleading representations in or related to Respondent's profession of midwifery. COUNT THREE 45. Petitioner realleges and incorporates paragraphs one (1) through thirty-four (34) and thirty-six (36) as if fully set forth herein. 46. Rule 64824-7.008(4), Florida Administrative Code (2001), states that: . ‘The midwife shall consult, refer or transfer to a physician | with hospital obstetrical privileges if the following occur during labor, delivery, or immediately thereafter: ... (i) Failure to progress in active labor 1. First stage: lack of a steady progress ine dilation and descent after 24 hours in primipara and 18 hours in multipara (A woman who has given birth at least two . times to an infant). 2, Second stage: more than two hours without progress in descent. .. . 47. - Respondent violated Rule 64B24-7.008(4), Florida Administrative Code (2001), by, not consulting, referring, or transferring - 410 K:\igracioEX ACs Kamecke 2002-25808 ACdoc el ‘d GerOk 9008 ¢e une 2e:07T 900¢ ¢e@ Une ~ “A patient IMF's care to a physician with hospital obstetrical privileges despite JMF's lack of steady progress in dilation and descent past twenty-four (24) | hours after JMF’s water breaking. 48, Based on the foregoing, Respondent is subject to discipline pursuant to section 467.203(1)(), Florida Statutes (June 2001), by violating Rule 64B24-7.008(4), Florida Administrative Code (2001). COUNT FOUR 49. ‘Petitioner realleges and incorporates paragraphs one (1) through thirty-four (34) as if fully set forth herein. 50. Rule 64B24-8.002, Florida Administrative Code (2001), states that engaging in unprofessional conduct, which includes, but is not limited to, any departure from, or the failure to conform to, the standards of practice of midwifery as established by the Department, in which case actual injury need not be established, shall be grounds for disciplinary ; action. | 51. Respondent engaged in unprofessional conduct by departing from, or failing to conform to, the standards of practice of midwifery during her care of patient JMF, including, but not limited to, the following: a. Not immediately assuming care of patient JMF when * Respondent was informed of JMF’s water breaking, 11) SeVignngeEX\ACs\xamela 2002-15808 AC.Goc tl od 9e7Ol 9008 é6 unr 2:07 900¢ 2@ Une causing patient JMF and patient JMF’s fetus to be left without care for about thirteen (13) hours after patient . IMF's water broke; b. Not administering antibiotics eighteen (18) ‘hours after : patient JMF’s water broke. c. Allowing and/or advising another midwife to administer Pitcocin without consulting a physician; d. Allowing and/or advising another midwife to administer Pitcocin intravenously to patient JMF with a hypodermic needle; e. Not transferring the care of patient JMF until forty (40) hours after JMF’s water broke; f. Informing Wellington that JMF’s water broke at 5:00 a.m., ‘ - April 30, 2002, when Respondent had knowledge that . — JMF’s water broke at 3:00 a.m., April 29, 2002; g. Not identifying herself to the attending physician at Wellington as being “Jenna Kameka” the midwife who had cared for JMF; and/or h. Not providing to the attending physician at Wellington » adequate patient records pertaining to the status and/or condition of patient JMF’s labor, patient JMF, and patient JMPF’s fetus. 52. Based on the foregoing, Respondent is subject to > dstpine, pursuant to section 467.203(1)(j), Florida Statutes (June 2001), by violating Rule 64824-8.002, Florida Administrative Code (2001), for 12 K:VignbdoX aCe \Ramcke 2002-15808 AC doc Gl ‘d 970 9008 é6 unr 2e:07T 900¢ ¢e@ Une engaging in unprofessional conduct by departing from, or failing to conform to the standards of practice of midwifery. WHEREFORE, Petitioner respectfully requests that the Council of Licensed Midwifery enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent’s license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of Respondent's license on probation, corrective. action, refund of fees billed or collected, remedial education and/or other relief that the Board deems appropriate. _ i 2 | st FILED OEP OEUTY GleRK asSiétant General Counsel cur Hothin Coloma plgtida Bar No. 0537683 oate__ Kl a.2a103 DOH, Prosecution Services Unit 4052 Bald Cypress Way, Bin # C-65 Tallahassee, FL. 32399-3265 (850) 414-8126 voice ECT:eci (850) 414-1989 facsimile Reviewed and approved by: DZ (initials) E/prdo¥{ dete) PCP: 6{(3/6> PCP Members: D © 13 K:VignactoEXyacs\Kanieka 2002-15808 AGdoc gL ‘d 970 9008 é6 unr 2e:07T 900¢ ¢e@ Une i. Tan DOH v. Jelena Kameka, Case No. 2002-15808 NOTICE OF RIGHTS Respondent has the right to request ahearingtobe | conducted in accordance with section 120.569 and 120.57, Florida Statutes (2002), to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses, and to have subpoena and subpoena decus tecum issued on his or her behalf if a hearing is requested. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred costs related to the investigation and prosecution of this matter. Pursuant to section 456.072(4), Florida Statutes (2002), the Board shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on Respondent in addition to any other discipline ‘imposed. 14 K:Vignaciotx\acis\xameke 2002-25808 AC.doc él‘d 970 9008 é6 unr Be:0T 900¢ ¢2é@ Unt

Docket for Case No: 06-002293PL